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INDONESIA
Indonesian Journal of Cancer
Published by National Cancer Center-Dharmais Cancer Hospital
ISSN : 19783744     EISSN : 23556811     DOI : https://www.doi.org/ 10.33371
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Public Health
Indonesian Journal of Cancer is a peer-reviewed and open-access journal. This journal is published quarterly (in March, June, September, and December) by Dharmais Cancer Hospital - National Cancer Center. Submissions are reviewed under a broad scope of topics relevant to experimental and clinical cancer research. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted acceptance for publication. The journal publishes original research articles, case reports, and review articles under the following categories: cancer management, cancer prevention, cancer etiology, epidemiology, molecular oncology, cancer diagnosis and therapy, tumor pathology, surgical oncology, medical oncology, radiation oncology, interventional radiology, as well as early detection.
Arjuna Subject : Kedokteran - Onkologi
Articles 12 Documents
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Search results for , issue "Vol 16, No 3 (2022): September" : 12 Documents clear
Laparoscopic Approach in Large Rare Adrenal Ganglioneuroma Kelvin Candiago; Egi Edward Manuputty; Syamsu Hudaya; Yulius Fajar Martanu; Budiawan Atmadja; Agnes Stephanie Harahap; Yosephine Gracia Susufi; Yustinus Hartanto; Ajeng Indah Pramesti
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.889

Abstract

Introduction: Adrenal ganglioneuroma is an extremely rare and benign tumor comprising Schwann cells and ganglion cells. Adrenal ganglioneuroma is usually hormonally silent and tends to be discovered incidentally on imaging tests. Here, we present a case of a 39-year-old man with adrenal ganglioneuroma who underwent laparoscopic left adrenalectomy.Case Presentation: a 39-year-old man was admitted to our department with left flank pain after he recovered from Covid-19. He had no symptoms of nausea, vomiting, headache, diarrhea, palpitation, or chest distress, and there was no lack of appetite or weight loss. He denied any medical conditions, such as hyperaldosteronism, hypercortisolism, and hypertension. On further examination with contrast-enhanced CT identified a hypo-isodense mass in the left adrenal gland, measuring 4.8 x 4.4 x 5.0 cm, and spotty dense calcification in the middle of the mass. All functional laboratory evolution showed negative including urinalysis and serum electrolyte. Because the non-functioning suprarenal tumor was presumed to be benign, a laparoscopic approach was planned for definitive extirpation of the left adrenal gland. CT triple-phase whole abdomen was done before the procedure which showed contrast-enhanced identified an isodense mass with 43 HU in the left adrenal gland, measuring 4.8 x 4.4 x 5.0 cm with absolute washout of 49.3% and relative washout of 30.7%. Laparoscopic left adrenalectomy was performed. The patient underwent successful laparoscopic extirpation of the left adrenal gland. The postoperative pathology revealed a 7.0 x 6.0 x 3.0 cm encapsulated tumor with a firm texture. Microscopically, the tumor showed a mixture of mature ganglion cells and fascicles of Schwann cells. Adrenocortical cells were found near the capsule.Conclusions: Even though there have been some guidelines for the diagnosis of Adrenal ganglioneuroma, pre-operative misdiagnoses are still frequent. We recommend that complete operative resection should be considered once malignancy cannot be excluded by pre-operative evaluation. Laparoscopic adrenalectomy is a reasonable option at least for tumors < or = 4.5 cm. Adrenal ganglioneuroma can be successfully excised laparoscopically with an appropriate and experienced surgeon.
Adverse Cutaneous Drug Reaction Following Granulocyte Colony-Stimulating Factor Administration in Nasopharynx Cancer Patient with Febrile Neutropenia: A Case Report Randy Adiwinata; Andrea Livina; Harlinda Haroen; Linda Rotty; Paul N Harijanto; Agung Nugroho; Cecilia Hendratta; Pearla Lasut; Christian Kawengian
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.878

Abstract

Introduction: Several side effects may occur during cancer treatment such as myelosuppression following systemic chemotherapy, which is mainly manifested as neutropenia and is associated with increased infection risk. Febrile neutropenia is associated with a worse prognosis. Granulocyte colony-stimulating factor (G-CSF) may be given prophylactically before chemotherapy in selected cases or as adjuvant therapy in febrile neutropenia. G-CSF administration may be associated with several side effects, including skin manifestation. More rarely, G-CSF administration may induce acute febrile neutrophilic dermatosis is which known as a Sweet syndrome. Case Presentation: A 63-year-old man with nasopharyngeal cancer stage III on chemotherapy and radiotherapy came to our emergency department with a chief complaint of fever, coughing, and shortness of breath. He was diagnosed with community-acquired pneumonia and febrile neutropenia. His white blood cell (WBC) count was 200/mm3 . On the third day of hospitalization and G-CSF administration, he developed a rash and had skin desquamation mainly on his head including the scalp, face, lips, upper trunk, arms, and the surface of both hands. His follow-up laboratory result was WBC 8300/mm3 with a neutrophil count of 87%. Presumable Sweet syndrome diagnosis with differential diagnosis of other drug eruption reactions was made. Systemic and topical were administered, and G-CSF was stopped. Significant improvement was observed. Conclusions: G-CSF administration in febrile neutropenic cancer is generally safe; however, several adverse events may occur. Cutaneous adverse events following G-CSF administration should be recognized and treated accordingly. Sweet syndrome is rare but should be recognized as a possible G-CSF-induced drug skin complication.
CXCR4 and MMP-9 Immunoexpression are Associated with Metastasis in Infiltrating Urothelial Carcinoma of The Bladder Siska Dwiyantie Wahyuni; Sri Suryanti; Hasrayati Agustina; Bethy Suryawathy Hernowo
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.892

Abstract

Background: Infiltrating urothelial carcinoma of the bladder (IUCB) is an aggressive urinary tract cancer. Most of the patients were diagnosed with advanced stages, and many have metastasized. Metastasis is responsible for 90% of cancer deaths compared to the primary tumor itself. In previous research, the expression of CXCR4 and MMP-9 has been suggested to correlate with metastasis and prognosis in several cancers. This study aimed to analyze the association of CXCR4 and MMP-9 expression with metastasis in infiltrating urothelial carcinoma of the bladder. Methods: This cross-sectional study included 40 selected paraffin-embedded tissue blocks from histopathologically diagnosed IUCB patients, consisting of 20 cases of non-metastasizing and 20 cases of metastasizing IUCB. Immunohistochemical staining for CXCR4 and MMP-9 was performed in all cases. All data were analyzed using the Chi-Square test with p < 0.05 of a significant level and then processed using SPSS 24.0 for Windows.Results: High CXCR4 immunoexpression was found in 18 (45%) of all cases, and high MMP-9 immunoexpression was found in 19 (47.5%) cases. High immunoexpression of CXCR4 and MMP9 in infiltrating urothelial carcinoma of the bladder showed significant association with metastasis (p < 0.05). The stepwise logistic regression analysis revealed that both CXCR-4 and MMP-9 immunoexpressions were independent prognostic factors for metastasis.Conclusions: CXCR4 and MMP-9 play a role in the metastatic process in infiltrating urothelial carcinoma of the bladder.
The Debulking of Recurrent Right Testicular Seminoma with Anterolateral Thigh Flap Reconstruction Syifa Fauziah Fadhly; Rachmat Budi Santoso; Edward Usfie Harahap; Dewi Aisiyah Mukarramah; Kasih Rahardjo Djarot; Ikhlas Arief Bramono; Rosalina Rosalina; Kardinah Kardinah; Rizky Ifandriani Putri
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.902

Abstract

Introduction: Radical orchidectomy is considered both a therapy and a part of the staging procedure. Stage I seminoma may be treated with orchiectomy alone while the remaining 15% to 20% may have a relapse if they receive no additional treatment during the five-year surveillance. Most recurrences occur within the first 2 years after diagnosis, and the location of the recurrence is typically in the retroperitoneum. This article aims to share the experience in the management of testicular seminoma recurrence in a multidisciplinary approach.Case Presentation: We are reporting a case of a 26-year-old male with a growing mass at the right scrotum just two months after right radical orchidectomy. This patient was previously treated with a stage I seminoma and underwent surveillance. Tumor debulking and right inguinoscrotal reconstruction using a pedicled anterolateral thigh (ALT) flap were done through collaborative surgery between urology and plastic surgery. However, according to National Comprehensive Cancer Network (NCCN), with the relapsed mass, this patient can be classified as having a stage III seminoma and considered as having a good-risk disease due to no evidence of non-pulmonary visceral metastasis. With the risk of bleomycin causing lung fibrosis, four cycles of etoposide and cisplatin can be considered the chemotherapy regimens for this patient. Evaluation after chemotherapy should be done by checking tumor markers and imaging studies.Conclusions: The reappearance of testicular seminoma in this patient unexpectedly occurred quite in a short period, that is in two months after surgery. Immediate multidisciplinary intervention by a urologist and plastic surgeon was done through tumor debulking with a wide incision margin and ALT flap reconstruction. Unfortunately, however, after the second month of follow-up, there was a bulging mass growing beneath the flap which needed further evaluation with ultrasonography to confirm the possibility of tumor recurrence or seroma. If tumor recurrence is confirmed, chemotherapy should be scheduled as soon as possible.
Post-Supravaginal Hysterectomy for Bladder Flap Hematoma in P3A0 Preterm Delivery by Cesarean Section due to Fetal Distress Andi Kurniadi; Rose Dita Dita Prasetyawati; Heti Prasekti
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.877

Abstract

Introduction: Bladder flap hematoma (BFH) is a rare complication of cesarean section (CS). BFH appears between the bladder and the lower uterine segment (LUS) when the visceral peritoneal is closed during traditional CS techniques and decreased uterine contractions. Surgery is the treatment of choice for the management of peritoneal closure in CS and the decrease in uterine contractions that cause BFH.Case Presentation: A 35-year-old G3P2A0 underwent a cesarean delivery due to fetal distress. CS was performed with the visceral peritoneal sutured as in the traditional technique. Six hours after CS, there was an increase in abdominal circumference, muscle defenses, hypotension, tachycardia, anemia, and leukocytosis. She had to undergo repeated laparotomy with acute abdomen after CS and hysterectomy because uterine atony was found.Conclusions: BFH can be caused by peritoneal closure during CS and decreased uterine contractions or uterine atony. Although there is no standard protocol for management, surgical approaches for cases with infection or bleeding and hysterectomy are performed to save the patient’s life from uterine atony.
Histopathological Features of the Lung Parenchyma in a 64-Year-Old Male Patient with Post-COVID-19 Infection with Spontaneous Pneumothorax Dextra Due to AlveolarPleural Fistula (APF): A Case Report Putu Erika Paskarani; Ni Wayan Winarti; Santi Maya Lestari Siahaan; Made Dalika Nareswari
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.888

Abstract

Introduction: Histopathological features of the lung parenchyma due to the Alveolar-Pleural Fistula (APF) in a patient with post-COVID-19 infection have not been reported. APF usually occurs after a spontaneous pneumothorax. Spontaneous pneumothorax is an abnormal traumatic accumulation of air within the pleural space. It is classified as primary or secondary pneumothorax based on multiple risk factors.Case Presentation: A sixty-four-year-old patient was referred from one of the remote hospitals in the west of Bali due to spontaneous simple pneumothorax dextra. A week after being diagnosed with COVID-19 infection, the patient underwent a bullectomy procedure and was clinically diagnosed with recurrent spontaneous pneumothorax dextra due to APF. Then, the bullectomy specimen was sent to the anatomical pathology laboratory. Histopathology test revealed extensive areas of necrosis and fibrosis with scattered lymphocytes and emphysematous alveoli found in APF lesions. Conclusions: In conclusion, the evidence of extended fibrosis, which destroys the pulmonary parenchymal septum and dilated alveoli with diffuse fibrosis in the subpleural and intraparenchymal areas, may cause impairment of both perfusion and ventilation. Unfortunately, viral cytopathic like-changes related to COVID-19, such as multinucleated cells with large nuclei, amphophilic cytoplasm, and prominent nucleoli in alveolar spaces with intranuclear inclusions, were not found in this case. In this case, surgery is needed in case of fistula, either related or unrelated to infection of the pleural cavity indicating the patient’s functional recovery.
Blood Pressure Elevation Timing Following Hysterectomy Kartiwa Hadi Nuryanto; Kanadi Sumapraja; Marcel Elian Suwito; Eka Rusdianto Gunardi; Seno Adjie; Tofan Widya Utami
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.901

Abstract

Background: Hysterectomy is the most common non-obstetric surgery in adult, reproductive-age women. Hysterectomy with or without ovarian conservation is known to increase the risk of cardiovascular disease. However, only a few studies regarding its immediate and short-term effects on hypertension are available. This study aimed to determine changes in blood pressure after a hysterectomy procedure.Methods: This study is a prospective cohort study of patients who underwent a total hysterectomy procedure with or without ovarian conservation at Cipto Mangunkusumo Hospital, Indonesia, from July 2018 to July 2020. Samples were grouped into patients with total hysterectomy only or hysterectomy with ovarian conservation (HT/HTSOU) and bilateral salpingo-oophorectomy hysterectomy (HTSOB). Statistical analysis was done using paired t-test and Wilcoxon test. Results: There were 80 patients included in this study (40 for each group). A significant increase in all blood pressure components occurred at 12 months after the HT/HTSOU and HTSOB procedures (p < 0.05). After six months of the HTSOB procedure, the increase in blood pressure components only occurred in systolic blood pressure and mean arterial pressure (MAP) (p < 0.05).Conclusions: There was a significant increase in all blood pressure components in the HT/HTSOU and HTSOB group at 12 months following hysterectomy while there was a significant increase in systolic blood pressure and MAP in the HTSOB group at 6 months following hysterectomy.
Profile of Breast Cancer Patients with Radiotherapy in Hasan Sadikin Hospital Bandung Atikah Larasati; Marhendra Satria Utama; Adji Kusumadjati
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.873

Abstract

Background: Breast cancer is the most common cancer in women worldwide and in Indonesia. Most patients arrived at the hospital too late to receive the optimal benefit from breast cancer therapies, in which radiotherapy is one of the essential modalities. Radiotherapy is conducted as a local control by using the principle of ionizing radiation to eradicate the growth of cancer cells, hence reducing the chances of recurrence and enhancing survival rates. Some of the side effects include skin conditions that can manifest as redness and dry skin, fatigue, lymphedema, and chest wall fibrosis. Data and research on the profile of breast cancer patients with radiotherapy were still limited in Indonesia, particularly in West Java. This study aimed to assess the profile of breast cancer patients in Hasan Sadikin Hospital Bandung.Methods: This study was conducted with the retrospective descriptive quantitative method. The sampling technique was total sampling using 280 medical records of breast cancer patients with radiotherapy from January 1, 2018, until December 31, 2019, which were registered in the Hospital-Based Cancer Registry at the Radiotherapy Department, Hasan Sadikin General Hospital.Results: Breast cancer patients undergoing radiotherapy were mostly in the 45–54 years age group (36.4%). The most common chief complaint was a lump in the breast (66.4%), particularly in the left breast (45.0%). About 22.5% of all patients arrived at a locally advanced stage and 30.7% at an advanced stage with bone metastasis (10.6%), histopathological subtype Invasive Carcinoma No Special Type (IC-NST) (81.1%), and molecular subtype luminal B (9.6%). The most widely performed therapies were total mastectomy surgery (16.1%), neoadjuvant chemotherapy (62.9%), and complete adjuvant radiotherapy (47.1%) with External Beam Radiotherapy (EBRT) method using LINAC (71.1%).Conclusions: Breast cancer is a health burden in Hasan Sadikin General Hospital and remains one of the national health priorities. Further evaluation of management and follow-up studies need to be done to improve the implementation of therapies for patients and reduce the incidence rate
Breast Cancer in the Balinese Elderly Population: Analysis of the Hospital-Based Cancer Registry I Gusti Putu Suka Aryana; Putu A.T Adiputra; Yulan Permatasari; Pande K. A. Prayudi; Hendra P. Setiawan
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.895

Abstract

Background: The elderly population in Indonesia will continue to increase over the next few decades. Breast cancer is 22.9% of all female cancers, and aging is one of the biggest risk factors. The challenge in managing older cancer patients is the ability to accurately assess whether the expected benefits of treatment outweigh the risks. Epidemiological data is very important for research and the advancement of medical science in the future. Currently, the incidence of breast cancer in Indonesia is 26 per 100,000 population, but the incidence of breast cancer in the elderly is unknown.Methods: This is a descriptive study of all breast cancer cases recorded in the cancer registry of Sanglah General Hospital, the largest cancer registry in Bali. Statistical analyses were conducted using descriptive statistics with the Statistical Package for the Social Sciences version 16.0 (SPSS).Results: From 1997 until 2013, 1,020 cases of breast cancer among Balinese women of various ages were recorded, of which only 78 cases (7.6%) were attributed to the elderly (age ≥ 65 years). At the time of diagnosis, distant metastasis was recorded for 28.9% of the elderly, compared with 24.4% for the younger group of patients (age < 65 years). Locally advanced breast cancer (LABC) was also recorded higher in the elderly (49.4% vs. 47.5%). A lower proportion of primary surgical treatment was recorded for the elderly than for the younger group of patients (69.7% vs. 76.2%). A lower proportion of adjuvant therapy, either by chemotherapy or radiotherapy, was also recorded for the elderly (45.5% vs. 53.4% and 2.6% vs. 4.9%, respectively), but the proportion of adjuvant hormonal therapy was recorded higher in the elderly (1.3% vs. 0.7%). In contrast, palliative care was recorded higher in the elderly (7.7% vs. 5.7%). Unfortunately, no data about survival were available.Conclusions: There is a tendency for older women in Bali to have more advanced disease at the time of diagnosis and receive less surgical treatment as the primary therapy, but they are more likely to receive adjuvant hormonal therapy and palliative care than their younger counterparts. This information should be of major interest to clinicians.
Mixed-Lineage Leukemia Suci Iriani; Agus Alim Abdullah; Darwati Muhadi; Mansyur Arif
Indonesian Journal of Cancer Vol 16, No 3 (2022): September
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v16i3.875

Abstract

Introduction: Acute Leukemia with Mixed Lineage phenotype (MLL) is leukemia that consists of cells characterized by mixed lineage markers, both from myeloid and lymphoid cells. The incidence of this leukemia is only 2-5% of all acute leukemias and is considered to have a poor prognosis.Case Presentation: A seven-year-old girl was diagnosed with MLL. The results of immunophenotyping showed two blast populations with the expressions of CD33, CD34, HLA-DR, CD117, CD13, CD19, CD10, CD20, CyMPO, Cy CD79a, and morphological features of Acute Lymphoblastic Leukemia (ALL) and Acute nonLymphocytic Leukemia (AnLL) on bone marrow aspiration. The BCR-ABL examination showed the detected BCR-ABL p210 (Major breakpoint), the majority of which was found in chronic myeloid leukemia (CML) patients. There is no definite pathogenesis of BCR-ABL p210 (MBCR-ABL) in this patient. BCR-ABL can also present in 11–29% of ALL patients but is relatively rare in childhood ALL (1%–3%) and mostly expresses p190 (minor breakpoint (mBCR-ABL)). The p210 BCR-ABL transcript is detected in 30% of adults and 20% of childhood ALL patients with Philadelphia ALL. Conclusions: MLL with BCR-ABL p210 transcript is very rare in acute leukemia. Immunophenotyping tests can detect typical MLL profiles, and WHO has standardized the diagnosis for MLL.

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